Richard Wall, CPO

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

PS00000395 Issued in WA

Practice address

1900 116TH Ave NE
Suite 210
Bellevue, WA 98004-3052

Phone

(425) 451-8831

Fax

(425) 451-8831

NPI assigned

Aug 9, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253836800000",
    "number": "1508058991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 116TH AVE NE",
            "address_2": "SUITE 210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043052",
            "telephone_number": "425-451-8831",
            "fax_number": "425-451-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 116TH AVE NE",
            "address_2": "SUITE 210",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043052",
            "telephone_number": "425-451-8831",
            "fax_number": "425-451-8831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALL",
        "first_name": "RICHARD",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-09",
        "last_updated": "2009-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "WA",
            "license": "OI00000394",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "WA",
            "license": "PS00000395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9036963",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martin Purdon Rory Walker, MD
• Tiegan Walker, LMP
• Jonathan Robert Wall
• Kathy Wall
• Martin J Wall, MD
• Wallace W. Wong DDS
• Hubert Frederick Wallenfels, AAC
• Jennifer M Waller, LAT, ATC
• Michelle A. a. Waller, MA LMHCA
• Sarah Waller

• Prosthetist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Prosthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.